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Mansi Z, Taghouti M, Chamakh M, Chneti I, Rbai H, Chermiti W, Haggui A, Zaidi B, Gazzah W. Vascular complications of tibial exostosis: A case of popliteal vein thrombosis. Radiol Case Rep 2024; 19:2781-2784. [PMID: 38680745 PMCID: PMC11046042 DOI: 10.1016/j.radcr.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/29/2024] [Accepted: 04/01/2024] [Indexed: 05/01/2024] Open
Abstract
Tibial exostosis, also known as osteochondroma, is a common benign bone tumor found predominantly in adolescents and young adults. Vascular complications associated with this tumor, such as arterial occlusion and pseudoaneurysm formation, are rare but can lead to significant morbidity if not promptly diagnosed and managed. We present a case of a 25-year-old patient who presented with thrombosis of the left popliteal vein and a painless swelling in the popliteal fossa. Radiographic and CT angiography revealed an exostosis on the proximal tibia causing arterial occlusion and venous compression. Surgical resection of the exostosis via a posterior knee approach resulted in successful resolution of symptoms and a favorable outcome at a 12-month follow-up. Histopathological examination confirmed the benign nature of the tumor with no evidence of malignant transformation. This case highlights the importance of prompt recognition and surgical intervention in managing vascular complications associated with tibial exostosis. A multidisciplinary approach involving orthopedic and vascular specialists is crucial for achieving optimal outcomes in such cases.
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Affiliation(s)
- Zied Mansi
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
| | - Mohamed Taghouti
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
| | - Mohsen Chamakh
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
| | - Islem Chneti
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
| | - Hedi Rbai
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
| | - Wajdi Chermiti
- Department of Orthopedic Surgery, SAHLOUL University Hospital, Sousse, Tunisia
| | - Ali Haggui
- Department of Orthopedic Surgery, Hospital of Kasserine, Kasserine, Tunisia
| | - Bacem Zaidi
- Department of General Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
| | - Wael Gazzah
- Department of Urology, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
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Gazzah W, Najjai Y, Lahouar R, Mzoughi M, Mansi Z, Braiek S. Delayed surgical repair in double penile fracture: Insights and outcomes: A case report. Int J Surg Case Rep 2024; 118:109623. [PMID: 38615465 PMCID: PMC11033179 DOI: 10.1016/j.ijscr.2024.109623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Penile fractures, though rare, demand urgent surgical attention due to their potentially severe consequences. This case report illustrates the significance of prompt and comprehensive imaging with surgical exploration in managing a delayed presentation of a double penile fracture. CASE PRESENTATION A 27-year-old male sustained a penile injury during sleep, presenting to our department 36 h post-trauma. His clinical symptoms included significant penile swelling, deviation, and the characteristic 'eggplant' deformity. Ultrasonography revealed extensive subcutaneous edema and a substantial hematoma at the penile base, with a disruption in the tunica albuginea. Surgical exploration identified two distinct fractures in the corpora cavernosa, which were successfully repaired. The patient experienced a rapid and complication-free recovery, regaining full erectile function within four days. CLINICAL DISCUSSION This case underlines the anatomical complexity of penile fractures. Despite the delay in seeking medical attention, the outcome was favorable, challenging the notion that immediate surgery is crucial for avoiding long-term complications. The literature suggests that delayed surgery might not significantly impact long-term outcomes, especially in the absence of urethral involvement, a perspective supported by our case findings. CONCLUSION Penile fracture requires a nuanced approach to diagnosis and treatment. The case demonstrates that while immediate surgical intervention is ideal, delayed repair can also result in positive outcomes under certain conditions. This report contributes to the growing body of evidence suggesting the potential for re-evaluating current clinical guidelines for penile fracture management.
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Affiliation(s)
- Wael Gazzah
- University of Sousse, Faculty of Medicine, Department of Urology, Ibn El Jazzar Hospital, Kairouan, Tunisia.
| | - Yassine Najjai
- University of Sousse, Faculty of Medicine, Department of Urology, Ibn El Jazzar Hospital, Kairouan, Tunisia
| | - Rayen Lahouar
- University of Sousse, Faculty of Medicine, Department of Urology, Ibn El Jazzar Hospital, Kairouan, Tunisia
| | - Mahdy Mzoughi
- University of Sousse, Faculty of Medicine, Department of Urology, Ibn El Jazzar Hospital, Kairouan, Tunisia
| | - Zied Mansi
- University of Sousse, Faculty of Medicine, Department of Orthopedic Surgery, Ibn El Jazzar Hospital, Kairouan, Tunisia
| | - Salem Braiek
- University of Sousse, Faculty of Medicine, Department of Urology, Ibn El Jazzar Hospital, Kairouan, Tunisia
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Gazzah W, Mansi Z, Zaidi B. Contraceptive complication: Emergence of a bladder stone - A case report. Int J Surg Case Rep 2024; 118:109622. [PMID: 38615469 PMCID: PMC11033183 DOI: 10.1016/j.ijscr.2024.109622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Bladder stones, although rare in a healthy bladder, can emerge due to various factors, including obstructions in urinary flow, recurrent infections, and foreign bodies. Intrauterine contraceptive devices (IUCDs) are known for their potential to migrate from the uterine cavity, leading to unusual complications such as bladder stone formation. CASE PRESENTATION A 52-year-old woman, previously treated for a complicated urinary tract infection, presented with intermittent lower abdominal pain, dysuria, and hematuria. She had a history of an IUCD insertion 15 years earlier, which was later documented as missing. Diagnostic imaging revealed a large bladder stone, encasing the previously inserted IUCD. An open vesicolithotomy was performed, during which a stone measuring 6 × 5 cm was removed, revealing the IUCD within. The patient had an uncomplicated recovery with no further urinary tract infections at a 6-month follow-up. CLINICAL DISCUSSION The migration of an IUCD can lead to various complications, depending on its final location. The formation of bladder stones around a migrated IUCD is a rare but significant complication, necessitating a thorough diagnostic approach. Radiography and ultrasonography proved sufficient for diagnosing the intravesical migration in this case. CONCLUSION This case underscores the importance of considering a migrated IUCD in the differential diagnosis of patients presenting with urinary symptoms, especially those with a history of a missing IUCD. Timely diagnosis and management are crucial in preventing further complications.
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Affiliation(s)
- Wael Gazzah
- University of Sousse, Department of Urology, Ibn El Jazzar Hospital, Kairouan, Tunisia.
| | - Zied Mansi
- University of Sousse, Department of Orthopedic Surgery, Ibn El Jazzar Hospital, Kairouan, Tunisia
| | - Bacem Zaidi
- University of Sousse, Department of Surgery, Ibn El Jazzar Hospital, Kairouan, Tunisia
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Mansi Z, Ahmed M, Tounsi A, Chermiti W, Ali H, Bacem Z. A giant gluteal lipoblastoma in a 24-month-old girl: A case report. Int J Surg Case Rep 2024; 118:109583. [PMID: 38581938 PMCID: PMC11015436 DOI: 10.1016/j.ijscr.2024.109583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/08/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Lipoblastomas are rare benign tumors that arise from embryonic white fat and almost always occur in babies and children. CASE PRESENTATION Here, we report a case of a giant gluteal lipoblastoma in a 24-month-old girl that was successfully treated via complete resection. CLINICAL DISCUSSION The gluteal location as in this case is an exceptional location. These tumors generally are benign, and there have been no reports of metastasis. Local recurrence can occur, particularly with lipoblastomatosis, when excision is incomplete. Surgical resection is the treatment of choice. The goal is always complete resection with negative margins, but this can be difficult to obtain with lipoblastomatosis. No spontaneous resolution or reduction of lipoblastoma has ever been reported, and a recurrence rate of 14 % and 25 % is reported in cases of incomplete excision. CONCLUSION Lipoblastoma is a benign neoplasm of immature fat tissue occurring in infants. The gluteal region location is relatively rare. Imaging, especially MRI, is helpful in diagnosis and preoperative evaluation. An adequate pathological examination could bring huge benefits. Total surgical resection is the treatment of choice. Subtotal resection and "wait and see policy" may be discussed for highly risky intervention.
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Affiliation(s)
- Zied Mansi
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia.
| | - Mahmoudi Ahmed
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
| | - Abdelkader Tounsi
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
| | - Wajdi Chermiti
- Department of Orthopedic Surgery, Sahloul University Hospital, Sousse, Tunisia
| | - Haggui Ali
- Department of Orthopedic Surgery, Hospital of Kasserine, Kasserine, Tunisia
| | - Zaidi Bacem
- Department of General Surgery, Ibn El Jazzar University Hospital, Kairouan, Tunisia
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Mansi Z, Chamakh M, Atef L, Chermiti W, Ali H, Wael G. Delayed slipped capital femoral epiphysis after orif for subtrochanteric femur fracture. Int J Surg Case Rep 2024; 118:109593. [PMID: 38598981 PMCID: PMC11010788 DOI: 10.1016/j.ijscr.2024.109593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/12/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Slipped capital femoral epiphysis (SCFE) is a common phenomenon of the proximal femur in adolescents with an unclear etiology. It is more common in boys than girls and there does seem to be some predilection to race, weight, and age (Lehmann et al., 2006 [7]). CASE PRESENTATION We reported a 13-year-old boy who presented with unilateral SCFE following subtrochanteric left femur fracture, which was fixed by blade plate 6 monthes before the SCFE. The SCFE fixed by two cannulated screw. We aim to discuss the possible link between the surgical technique used for proximal femur fractures and the delayed onset of SCFE. CLINICAL DISCUSSION Slipped capital femoral epiphysis (SCFE) after treatment of subtrochanteric fracture can be caused by inadequate treatment of the fracture. Orthopedic surgeons should be aware of this complication so that they can promptly recognize this complication and treat it urgently (Chinoy et al., 2020). CONCLUSION Slipped capital femoral epiphysis (SCFE) after treatment of subtrochanteric fracture is a very rare condition, that it can be prevented by proper reduction and fixation of the fracture using appropriate osteosynthesis material.
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Affiliation(s)
- Zied Mansi
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia.
| | - Mohsen Chamakh
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
| | - Ltifi Atef
- Department of Orthopedic Surgery, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
| | - Wajdi Chermiti
- Department of Orthopedic Surgery, SAHLOUL University Hospital, Sousse, Tunisia
| | - Haggui Ali
- Department of Orthopedic Surgery, Hospital of Kasserine, Kasserine, Tunisia
| | - Gazzah Wael
- Department of Urology, IBN EL JAZZAR University Hospital, Kairouan, Tunisia
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Zaidi B, Sindi S, Belgacem L, Mansi Z, Gazzah W, Salah KB. Spontaneous gas gangrene of the pancreas: extremely rare condition. J Surg Case Rep 2024; 2024:rjae133. [PMID: 38585178 PMCID: PMC10994855 DOI: 10.1093/jscr/rjae133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/15/2024] [Indexed: 04/09/2024] Open
Abstract
Acute pancreatitis is a common condition, only occasionally leading to necrosis of the pancreas. In instances where abscess formation takes place, the predominant microbial profile involves both aerobic and anaerobic enteric species. We present the case of a patient with clostridial emphysematous pancreatitis who developed pneumoperitoneum without associated visceral perforation.
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Affiliation(s)
- Bacem Zaidi
- University of Sousse, Sousse 4200, Tunisia
- Les Aghlabides Hospital, Kairouan 3100, Tunisia
| | - Sihem Sindi
- University of Sousse, Sousse 4200, Tunisia
- Les Aghlabides Hospital, Kairouan 3100, Tunisia
| | - Leila Belgacem
- University of Sousse, Sousse 4200, Tunisia
- Les Aghlabides Hospital, Kairouan 3100, Tunisia
| | - Zied Mansi
- University of Sousse, Sousse 4200, Tunisia
- Les Aghlabides Hospital, Kairouan 3100, Tunisia
- Tunisian Society of Orthopedic and Traumatology Surgery, Tunis 1000, Tunisia
| | - Wael Gazzah
- University of Sousse, Sousse 4200, Tunisia
- Les Aghlabides Hospital, Kairouan 3100, Tunisia
- Urology Department, Kairouan 3100, Tunisia
| | - Khalil Ben Salah
- University of Sousse, Sousse 4200, Tunisia
- Les Aghlabides Hospital, Kairouan 3100, Tunisia
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Mansi Z, Aymen BM, Abdelkader T, Ali H, Wajdi C, Bacem Z. Bilateral acetabular fractures (case report). Int J Surg Case Rep 2024; 116:109424. [PMID: 38430896 PMCID: PMC10943949 DOI: 10.1016/j.ijscr.2024.109424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/15/2024] [Accepted: 02/17/2024] [Indexed: 03/05/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Bilateral acetabular fractures are very rare. They are usually seen in the context of multiple trauma patients. This type of fracture poses a problem and difficulty in therapeutic management, sometimes resulting in serious sequelae and significant morbidity. CASE PRESENTATION We report a rare case of bilateral simultaneous acetabular fracture in an adult, forty-seven years old man due to a road accident. CLINICAL DISCUSSION Bilateral acetabular fractures are very rare. While bilateral acetabular fracture most frequently occur due to automobile accidents, other mechanism can be responsible for this injury as well. Furthermore, bilateral acetabular fractures are frequently associated with other lesions of the surrounding bones or tissues. Surgery is the most suitable treatment in most cases. The development of osteoarthritis is the most common complication of acetabular fracture and is directly related to the post-operative reduction obtained. Heterotopic ossifications are a complication associated with acetabular fracture. In acetabular fracture, the primary objective of surgical treatment is anatomical reduction of the fracture that will determinate the future of hip. CONCLUSION The treatment goal of acetabular fracture is anatomic or near anatomic reduction of the articular surface. The risk of osteonecrosis is mostly related to the initial injury and time to reduction.
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Affiliation(s)
- Zied Mansi
- Ibn El Jazzar Hospital of Kairouan, Department of Orthopaedic and Traumatology, Tunisia.
| | - Ben Mahmoud Aymen
- Ibn El Jazzar Hospital of Kairouan, Department of Orthopaedic and Traumatology, Tunisia
| | - Tounsi Abdelkader
- Ibn El Jazzar Hospital of Kairouan, Department of Orthopaedic and Traumatology, Tunisia
| | - Haggui Ali
- Hospital of Kasserine, Department of Orthopaedic and Traumatology, Tunisia
| | - Chermiti Wajdi
- Sahloul Hospital of Sousse, Department of Orthopaedic and Traumatology, University of Sousse, Tunisia
| | - Zaidi Bacem
- Ibn El Jazzar Hospital of Kairouan, Department of General Surgery, University of Sousse, Tunisia
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Mansi Z, Rbai H, Saibi F, Saadana J, Chermiti W, Zaidi B. Our experience with the surgical management of lower cervical spine fractures: fifty case series. Int Orthop 2024; 48:817-830. [PMID: 38182851 DOI: 10.1007/s00264-023-06076-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/16/2023] [Indexed: 01/07/2024]
Abstract
PURPOSE Trauma to the lower cervical spine is a serious lesion due to its neurological consequences which jeopardize the vital and functional prognosis. They constitute a public health problem due to their frequency and seriousness requiring rapid and adequate treatment. The aim of our study is to (1) describe the epidemiological, clinical, and radiological characteristics of lower cervical spine trauma patients; (2) support the therapeutic management of these patients and show our experience in surgery for lower cervical spine trauma; and (3) analyze the anatomical and functional results and discuss them with literature data. METHODS This is a retrospective descriptive study of 50 patients with lower cervical spine trauma treated surgically over a period of five years from January 1, 2016, to December 2020. RESULTS The average age of our patients was 34.5 years, with a sex ratio of 1.7. The etiologies are dominated by accidents on public roads (58%). They show neurological disorders such as spinal cord damage in 30% of cases and root damage in 20% of cases. The radiological assessment revealed eight tear drops, ten comminuted fractures, 12 severe sprains, 12 biarticular dislocations, six uniarticular dislocations, and two herniated discs. Treatment was surgical in all patients with an anterolateral approach and anterior arthrodesis. The evolution was favourable in 21 patients and stationary in 29 patients. CONCLUSION Our study concluded that dislocations and fracture dislocations were the predominant type of injury in cases of AVP. Tetraplegia was mainly observed with uni- and biarticular dislocations. The variation in consolidation time was not correlated with trauma-to-surgery time. Better neurological recovery was observed with mild initial neurological damage than with initially severe damage. The appearance of an adjacent syndrome is less frequent with monosegmental arthrodesis than with multisegmental arthrodesis. Cage arthrodesis was an alternative to iliac harvesting with similar results.
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Affiliation(s)
- Zied Mansi
- University of Sousse, Sousse, Tunisia.
- Tunisian Society of Orthopaedic and Traumatolgy Surgery, Tunis, Tunisia.
| | - Hedi Rbai
- University of Sousse, Sousse, Tunisia
- Tunisian Society of Orthopaedic and Traumatolgy Surgery, Tunis, Tunisia
| | - Firas Saibi
- University of Sousse, Sousse, Tunisia
- Tunisian Society of Orthopaedic and Traumatolgy Surgery, Tunis, Tunisia
| | - Jacem Saadana
- Tunisian Society of Orthopaedic and Traumatolgy Surgery, Tunis, Tunisia
- University of Monastir, Monastir, Tunisia
| | - Wajdi Chermiti
- University of Sousse, Sousse, Tunisia
- Tunisian Society of Orthopaedic and Traumatolgy Surgery, Tunis, Tunisia
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